Provider Demographics
NPI:1447472352
Name:UNGER, GERALD NATHAN (MD,JD,LLM)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:NATHAN
Last Name:UNGER
Suffix:
Gender:M
Credentials:MD,JD,LLM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 TYLER AVE
Mailing Address - Street 2:BLDG. B
Mailing Address - City:EAST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02538-1328
Mailing Address - Country:US
Mailing Address - Phone:508-291-7777
Mailing Address - Fax:508-291-7774
Practice Address - Street 1:3 TYLER AVE
Practice Address - Street 2:BLDG. B
Practice Address - City:EAST WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02538-1328
Practice Address - Country:US
Practice Address - Phone:508-291-7777
Practice Address - Fax:508-291-7774
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA00000000209800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes209800000XAllopathic & Osteopathic PhysiciansLegal Medicine
No101Y00000XBehavioral Health & Social Service ProvidersCounselor